Loose Stools and EPI

[Ashley Thurman]

Is anyone here familiar with Exocrine Pancreatic Insufficiency? We have been battling loose stools with our F1B Goldendoodle since we brought him home. Our hollistic vet can't seem to figure out what's going on and said this would be the next step to test him for this if he doesn't respond to his new food. 

Here's a general timeline. 

Fine when we brought him home. Breeder was feeding Diamond Naturals. 

I slowly switched to Taste of the Wild and he had severe water diarrhea. Stopped that food. 

Switched to Fromm and he did fine for a while, although his stools have never been firm. They go from mudpie consistency to just formed but really soft stools. Then he had a vomiting episode and I took him to a vet I no longer visit who put him on some EN purina food. As soon as I realized what that was I took him off, put him back on the Fromm and found a hollistic vet who knew more about food. He did have one more vomiting episode in there, but only threw up once. 

During the vet change my trainer who is pretty knowledgeable with this stuff suggested a Limited ingredient diet with rabbit since it is hypoallergenic. He did ok on that for a while and had a few days of normal stools, but slowly starting having soft stools. 

We took him to the vet and she has done Bicom on him as well as some other supplements (leaky gut, enteric support, and another I forget the name of). While he started these supplements we did a chicken/rice diet for 2 weeks. I started him back on the Natural Balance Limited Ingredient Rabbit and he continued to have soft stools, then he got more normal and this morning it was almost like he was constipated with a very hard stool that looked like balls smooshed together. 

He's at the vet today getting neutered, and they are suggesting I change him to GO! Duck dog food, which I am ok with... but they also suggested a test for the EPI. 

I've looked it up some and it seems most dogs with this loose weight, while mine is gaining quickly and very energetic. He does seem to be hungry all the time which is a sign of EPI.... but he's not loosing any weight, his coat looks great. Other than the loose stools he's completely fine.... 

Anyone have any ideas? 

[Karen, Jasper and Jackdoodle]

I'm sorry you and your poor guy are going through all this. Exocrine pancreatic insufficiency is extremely rare in any breed other than German Shepherds and Rough-coated Collies. Those two breeds make up 90% of all all cases. There are a few owners of dogs with EPI in my IBD support group, and what you are describing with your dog sounds nothing at all like what these people and their dogs are going through.

However, since there is testing for EPI, I'd certainly have it done to rule that out and set your mind at ease.

How old is your dog? You don't mention fecal testing, I'm assuming that was done? Prior to seeing the holistic vet, has he been treated with metronidazole or any other drug? Any probiotics? 

I'm not real big on "natural" or "holistic" treatments that have no clinical evidence to back up their effectiveness, especially without a reliable diagnosis. You need to know what you're treating. 

IF your dog has an actual digestive disease as opposed to a sensitive stomach, and that's a big IF, it's far more likely that it would be Irritable Bowel Syndrome or Inflammatory Bowel Disease; both are seen in doodles. The former is basically a nervous stomach that can be managed with the right diet and supplements; the latter is a serious immune-mediated disease of the lining of the GI tract that requires some very expensive diagnostic testing and then an appropriate treatment that incorporates both diet and medication.

However, it's also likely that this might be the result of over-zealous use of worming meds and antibiotics in puppyhood.

I prefer to make food recommendations inn The Food Group; however, it sounds like your dog needs an LID diet, preferably grain-free, and a good probiotic.  And you need to stop "trying out" so many different protein sources or you're going to run out of novel proteins. Food sensitivities and allergies develop after a dog has been eating the same protein repeatedly for a long period of time. In case of Inflammatory Bowel Disease, if you introduce a protein while there is inflammation present, the dog will develop a sensitivity to that protein, which is why you reserve things like rabbit for situations where you really need them. 

But most of all, he needs an accurate diagnosis. I hope you can get some answers.

[Wendy and Myla]

Our last doodle, Zak, had EPI.  I'm not going to be much help because I have blocked a lot out and I threw out her file about a year ago with all of the vet readouts and bills.  It was a devastating time for us.  I will tell you what I remember. When Zak was just two years old, on Easter Sunday, she was laying down and could not get up.  We had a house full of company and when we called her, she tried, but could not get up.  I rushed her to an ER clinic and they had no idea what the problem was.  They gave her relaxants and a while later she was fine.  About two months later (June) she was having very loose stools and very yellowish in color.  We were feeding her Kirkland dog food from Costco.  She was gobbling up her food like crazy and if we fed her more, she would eat more!  She was still very active and everything seemed normal except her stools and she had so many stools per day.  The vet asked me to bring in a stool sample and they really couldn't figure out why they were so loose and why she had so many.  Then she started loosing weight and rapidly.  The vet then did a test for EPI and her levels were very bad.  As I said, I don't have any of the records but her pancreas was not working at all!!!  She went from 59 pounds to 35 pounds very quickly.  She was dying in front of our eyes.  Our vet conferred with a specialist in EPI and we put her on very expensive medication (I forget the name) and a very low fat dog food (I forget the name of that also, but I know that it is not on the recommended list) but we did exactly what the vet told us.  We had to give her pills before each meal so that she could digest the food (which is what the pancreas is supposed to do) - I remember crying because I knew that if we had to do this for her life, we could not afford it.  Once she was on the medication for a while, her stools were firmer and she started gaining weight back.  She never regained her full weight, though that was our goal, but she did get to 50 pounds.  Her back end always felt skeletal.  Once she was getting back to normal, we cut down on the pills and got it down to four a day, which was still expensive but manageable.  As soon as she got stressed from anything, we had to increase her pills.  We were always watching her stools for signs.  She always had to be on a low fat diet and absolutely no treats (mainly because she needed pills to digest treats, and most treats have fat).  It is a terrible illness and I have learned to respect the pancreas immensely.  Zak lived to the age of five, which surprised the vet and she had an awesome life.  She did a lot of hiking and camping and kayaking with us - we just had to make sure that she didn't drink from streams, rivers or eat anything that was not her food.  We were lucky that she did not like swimming at all so drinking from those sources wasn't really a problem. I'm really not sure what life expectancy is for dogs with EPI but I know that our vet was surprised that Zak did so well, considering her levels.  I would definitely get the test done for EPI - I know it's expensive, but the sooner you learn if Emmet has it, the sooner you can figure out what has to be done for him and especially catch it before he starts losing weight, because it is really hard to regain the lost weight as you have to limit the fat in his diet.  I really hope that he doesn't have this disease and I wish you the very best!!! 

[Karen, Jasper and Jackdoodle]

I'm so sorry, Wendy.

What you are describing is what I hear from other owners of EPI dogs. It really is a devastating disease. 

[Wendy and Myla]

Thanks Karen - it's really hard to talk about!

[Nancy, Ned, Clancy, and Charlie]

Wendy, I am so sorry you and Zac had to go through this.

[Wendy and Myla]

Thanks Nancy - It was a hard time and I really wish that I knew about DK at the time - I'm sure it would have helped!

[Stella]

I have a client who has a 13 year old GSD with EPI. He has been managed his whole life with enzymes and a home cooked diet. Now he has other 'old dog' problems, but up until very recently he has been a healthy weight and very fit and active.